Nerve mobilization techniques have been recently used as a method to adjust radiating pain related to disk disease, and in particular, mobilization techniques for the sciatic nerves improve the mobility of the sciatic nerves, decrease mechanosensitivity of the nervous system, and heighten compliance of nerve tissues, relieving low back pain.
Through such mobilization techniques, damages to the sciatic nerves may be removed, pain may be alleviated, and range of motion may be increased, and dynamic adaptability of the nervous system may be heightened, helping to patients to use their bodies without resistance.
When tension is applied to the nervous system during the mobilization techniques for the sciatic nerves, the cross-section of the nerves decreases and therefore small blood vessels that cross the epineurium are obstructed, thereby adjusting the amount of blood to the nerve fibers. This affects the axonal transport system, and increased flexibility of the shortened nerves and surrounding joint structures leads to increased muscle strength, as the improved flexibility of the sciatic nerves decreases mechanosensitivity of the nervous system, which in turn heightens compliance of the nerve tissues.
Study by Cleland et al. On chronic back pain patients, in which the subjects were divided into (1) a lumbar spinal mobilization and exercise group and (2) a lumbar mobilization, exercise and slump stretching group. They concluded that second group showed better results on numeric pain rating scale(NPRS), Oswestry Disability index(ODI).
A study by Kavlak & Uyaur, who applied a nerve mobilization technique to carpal tunnel syndrome patients and obtained positive outcomes in pain, range of motion and a sensory test.
In relation to lumbar intervertebral disk diseases, traditional lumbar stabilization training has recently been performed with a main focus on promotion of muscular functions and nerve root adjustment. The techniques to mobilize sciatic nerves have been used as a method to verify dynamic sensitivity of the nerves and whether this is neuritis, and like the study of Cleland et al, there have been many studies that have applied indirect nerve system mobilization to chronic low back pain patients without radiating pain in the lower limbs. However, a few studies have indicated that nerve system mobilization techniques improve adaptability of the nerves and dynamic adaptability and have positive effects that decrease pain and increase range of motion and reported them as methods of treating low back pain.
Therefore, classical treatment methods and spinal mobilization techniques are important in therapy to decrease the mechanical stress caused by restriction of the range of motion of the hip joint or sacroiliac joint due to an increase in tension of the hamstrings resulting from stimulation of the sciatic nerves, but it is desirable to improve the causes through direct neural mobilization. Therefore, mobilization techniques for the sciatic nerves recommended as a therapeutic method for patients with chronic low back pain accompanied by radiating pain reduce the burden on the waist by increasing flexibility as a result of extension of the hamstrings and triggering good results that reduce oversensitivity and stimulation of the sciatic nerves caused by radiating pain in the lower limbs. These techniques are therapeutically recommended for patients with low back pain accompanied by radiating pain.
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- Fritz JM, Cleland JA, Speckman M, et al. : Physical therapy for acute low back pain: associations with subsequent healthcare costs. Spine, 2008, 33: 1800–1805. [PubMed]
- Marshall PW, Mannion J, Murphy BA: The eccentric, concentric strength relationship of the hamstring muscles in chronic low back pain. J Electromyogr Kinesiol, 2010, 20: 39–45. [PubMed]
- The effects of self-mobilization techniques for the sciatic nerves on physical functions and health of low back pain patients with lower limb radiating pain Ui-Cheol Jeong, MS, Cheol-Yong Kim, PT, PhD, Young-Han Park, PT, PhD,Gak Hwang-Bo, PhD, and Chan-Woo Nam, PT, MS
Disclaimer: Above information is only for educational purpose, don’t try on your patient if you are not through for technique